Outcome for Children and Young Adults With T-Cell ALL and Induction Failure in Contemporary Trials.
Journal
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
ISSN: 1527-7755
Titre abrégé: J Clin Oncol
Pays: United States
ID NLM: 8309333
Informations de publication
Date de publication:
10 Nov 2023
10 Nov 2023
Historique:
pmc-release:
10
11
2024
medline:
9
11
2023
pubmed:
24
7
2023
entrez:
24
7
2023
Statut:
ppublish
Résumé
Historically, patients with T-cell acute lymphoblastic leukemia (T-ALL) who fail to achieve remission at the end of induction (EOI) have had poor long-term survival. The goal of this study was to examine the efficacy of contemporary therapy, including allogeneic hematopoietic stem cell transplantation (HSCT) in first remission (CR1). Induction failure (IF) was defined as the persistence of at least 5% bone marrow (BM) lymphoblasts and/or extramedullary disease after 4-6 weeks of induction chemotherapy. Disease features and clinical outcomes were reported in 325 of 6,167 (5%) patients age 21 years and younger treated in 14 cooperative study groups between 2000 and 2018. With a median follow-up period of 6.4 years (range, 0.3-17.9 years), the 10-year overall survival (OS) was 54.7% (SE = 2.9), which is significantly higher than the 27.6% (SE = 2.9) observed in the historical cohort from 1985 to 2000. There was no significant impact of sex, age, white blood cell count, central nervous system disease status, T-cell maturity, or BM disease burden at EOI on OS. Postinduction complete remission (CR) was achieved in 93% of patients with 10-year OS of 59.6% (SE = 3.1%) and disease-free survival (DFS) of 56.3% (SE = 3.1%). Among the patients who achieved CR, 72% underwent HSCT and their 10-year DFS (with a 190-day landmark) was significantly better than nontransplanted patients (63.8% [SE = 3.6] Outcomes for patients age 21 years and younger with T-ALL and IF have improved in the contemporary treatment era with a DFS benefit among those undergoing HSCT in CR1. However, outcomes still lag considerably behind those who achieve remission at EOI, warranting investigation of new treatment approaches.
Identifiants
pubmed: 37487146
doi: 10.1200/JCO.23.00088
pmc: PMC10642910
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5025-5034Subventions
Organisme : NCI NIH HHS
ID : U10 CA098413
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA021765
Pays : United States
Organisme : NCI NIH HHS
ID : U10 CA098543
Pays : United States
Organisme : NCI NIH HHS
ID : U10 CA180899
Pays : United States
Organisme : NCI NIH HHS
ID : U10 CA180886
Pays : United States
Références
J Clin Oncol. 2012 May 10;30(14):1663-9
pubmed: 22412151
Lancet Oncol. 2014 Jul;15(8):809-18
pubmed: 24924991
Blood. 2010 Apr 22;115(16):3206-14
pubmed: 20154213
Br J Haematol. 2014 Aug;166(3):421-4
pubmed: 24708207
Nat Genet. 2017 Aug;49(8):1211-1218
pubmed: 28671688
Lancet. 2005 Aug 20-26;366(9486):635-42
pubmed: 16112299
Blood. 2022 Mar 24;139(12):1785-1793
pubmed: 34192312
Lancet Haematol. 2016 Feb;3(2):e80-6
pubmed: 26853647
Blood Adv. 2019 Nov 26;3(22):3688-3699
pubmed: 31765480
Leukemia. 2020 Feb;34(2):336-346
pubmed: 31534171
Hematology Am Soc Hematol Educ Program. 2016 Dec 2;2016(1):580-588
pubmed: 27913532
Lancet Oncol. 2015 Dec;16(16):1677-90
pubmed: 26549586
Blood. 2008 May 1;111(9):4477-89
pubmed: 18285545
Int J Hematol. 2018 Jul;108(1):98-108
pubmed: 29589281
Br J Haematol. 2013 Oct;163(2):240-7
pubmed: 23937310
J Clin Oncol. 2020 Oct 1;38(28):3282-3293
pubmed: 32813610
Stat Med. 2015 Dec 10;34(28):3648-60
pubmed: 26215851
Blood. 2011 Aug 25;118(8):2077-84
pubmed: 21719599
Recent Results Cancer Res. 1993;131:269-82
pubmed: 8210646
J Clin Oncol. 2008 Mar 20;26(9):1496-503
pubmed: 18349402
N Engl J Med. 2006 Jan 12;354(2):166-78
pubmed: 16407512
J Clin Oncol. 2006 Dec 20;24(36):5742-9
pubmed: 17179108
Cancer. 1999 Mar 15;85(6):1395-404
pubmed: 10189148
Leukemia. 2020 Feb;34(2):347-357
pubmed: 31611626
N Engl J Med. 2012 Apr 12;366(15):1371-81
pubmed: 22494120
J Clin Oncol. 2016 Aug 1;34(22):2591-601
pubmed: 27269950
J Clin Oncol. 2022 Jul 1;40(19):2106-2118
pubmed: 35271306
J Clin Oncol. 2017 Feb 20;35(6):660-667
pubmed: 28045622
Blood. 2016 Apr 28;127(17):2101-12
pubmed: 26888258
J Clin Oncol. 2003 Oct 1;21(19):3616-22
pubmed: 14512392
J Clin Oncol. 2018 Oct 10;36(29):2926-2934
pubmed: 30138085
Blood. 1993 Jul 15;82(2):343-62
pubmed: 8329694
Br J Haematol. 2019 Sep;186(5):741-753
pubmed: 31124581
Blood Cancer J. 2020 Feb 27;10(2):23
pubmed: 32107374